Objective:To investigate the association of Subclinical Carotid AtheroSclerosis (SCAS) and prediabetes or Diabetes Mellitus (DM)in the healthy people.Methods:From September 2018 to June 2019, participants who underwent physical examination in the Health Management Center of Beijing Tiantan Hospitial were enrolled consecutively. The baseline characters were collected prospectively. Carotid Ultrasound was evaluated by radiologists according to the standard operating protocol. Univariable analysis and multivariable logistic analysis were used to estimate the association of prediabetes or DM with SCAS.Results:Totally 401 participants were eligible and enrolled. The mean age was (52.2±10.4) years and 43.7% (252/401) of them were females. The prevalence of DM and SCAS were 16.4% (66/401) and 48.9% (196/401) respectively. In the univariate analysis, elder age (≥60 years old) ( OR=5.93, 95% CI: 3.86-9.09, P<0.001), hypertension ( OR=2.76, 95% CI: 1.84-4.15, P<0.01), prediabetes( OR=1.67, 95% CI: 1.08-2.58, P<0.05) and DM ( OR=3.60, 95% CI: 1.97-6.58, P<0.01), cigarettes smoking ( OR=2.64, 95% CI: 1.82-3.81, P<0.001), lower HDLlevel<1.04 mmol/L ( OR=1.58, 95% CI: 1.04-2.42, P<0.001) and hyperhomocysteinemia (≥15 μmol/L)( OR=1.69, 95% CI: 1.17-4.04, P<0.01) were associated with higher prevalence of SCAS. On the contrary, female sex ( OR=0.53, 95% CI: 0.39-0.74, P<0.001) was associated with lower prevalence of SCAS. In the multivariable logistic analysis, elder age(≥60 years old) ( OR=6.04, 95% CI: 3.13-11.7, P<0.01), hypertension ( OR=2.14, 95% CI: 1.13-3.87, P<0.05), cigarettes smoking ( OR=2.19, 95% CI: 1.21-3.98, P<0.05) and DM ( OR=2.32, 95% CI: 1.16-4.67, P<0.05) were associated with SCAS independently. The association between prediabetes and SCAS was not statistically significant. Conclusions:DM is independently associated with SCAS in neurological healthy people, while prediabetes tended to increase the risk of SCAS.

Objective:This study is to improves the understanding of adenoid cystic carcinoma (ACC) of the tracheobronchial tree by observing the multi-slice cornputed tomography (MSCT) features. Methods:The MSCT features of 19 cases with primary tra-cheobronchial ACC confirmed by histopathology were retrospectively analyzed. Results:Among the 19 cases, lesions were located in the trachea in seven cases, in the segmental and above segmental bronchi in 10 cases, in the peripheral lung in two cases. Intra-and ex-traluminal growth were observed in 15 cases (79%), whereas broad-based intraluminal lesions were exhibited in two cases (11%). Among the seven cases of tracheal ACC, the CT scans for five cases showed a notable tendency toward submucosal extension. Two cas-es manifested as a diffuse or circumferential wall thickening of the trachea, and the other three cases presented homogeneous mass fill-ing of the trachea with wall thickening. The 10 cases with bronchial ACC were manifested as intra-and extraluminal growth. Eight cas-es presented homogeneous polypoid growth toward the adjacent lumen, and seven cases presented extraluminal parts that were larger than the intraluminal parts. Among 13 contrast-enhanced examinations, three cases were without enhancement, five cases were slightly enhanced, four cases were moderately enhanced, and one case was highly enhanced. Conclusion:MSCT performances of ACC of the tracheo-bronchial tree possessed certain characteristics, such as broad-based mass, intra- and extraluminal growth, and diffuse wall thickening. CT can diagnose tumor malignancy, but the definitive diagnosis for ACC should depend on pathology.

s correlated with coronary disease. Examining these peripheral arteries, more efficient in combination, seems to be a helpful way for screening coronary disease.

Objective To observe the change of learning and memory and the expression change of GABAR1 and N-methyl-D-aspartate receptor 2B (NMDAR2B)in right frontal lobe of the brain of the aged rats after the inhalation of sevoflurane.Methods Fifty male SD rats were randomly divided into control group (group C,n=10)and experimental group (group T,n=40).The control group received air at room tempreture.Experimental groups were divided into two groups:group T1 (2 h)and group T2 (4 h)according to the time of inhalation of sevoflurane at 3% concentration.Ev-ery group was equally divided into two groups and Morris water maze was performed on day 1 and day 7 after sevoflurane inhalation.Then the right frontal lobe was gathered and the mRNA transcription and protein expression of GABAR1 and NMDAR2B were detected by Quantitative Real-time PCR and immunofluorescence technique.Results Compared with group C,the escape latency was prolonged in groups T1 and T2 after 1 day of inhalation of sevoflurane (P<0.05),and the times of space explora-tion reduced (P<0.05).mRNA transcriptional and protein content of GABAR1 were significantly upregulated in frontal lobes of groups T1 and T2,mRNA transcriptional and protein content of NMDAR2B were significantly down-regulated (P<0.05).After inhalation of sevoflurane for 7 days, the protein expression of NMDAR2B in the frontal lobe of group T1 was lower than that of group C (P<0.05).In group T2,the escape latency was prolonged (P<0.05),the number of space explo-ration traversals was decreased (P<0.05),the expression of GABAR1 protein in frontal lobe was up-regulated (P<0.05),and the expression of NMDAR2B protein was down-regulated (P<0.05), and the amplitude was higher than that in group T1 (P<0.05).Conclusion Continuous inhalation of sevoflurane can reduce the spatial memory ability of aged rats,and the effect of prolonged inhalation is greater and longer.This effect is related to the expression of neurotransmitter receptors such as GABAR1 and NMDAR2B in the frontal lobe.

Objective To understand the status and main influence factors of customer satisfaction in the physical examination .Methods Three hundred and sixty-six customers were surveyed by the self-designed physical examination satisfaction questionnaire in order to understand the physical examination -related knowledge of customer and customer satisfaction and analyze the influence factors .Results Four hundred questionnaires were issued and 366 questionnaires were responsive with an effective response rate of 96.2%.The customer satisfaction to the overall service quality was 96.2%, and the difference was found in the different gender (χ2 =-2.27 ,P<0.05 ) .The service guide satisfaction was 93.4%, and the difference was found in the different age (χ2 =24.974 ,P<0.01 ) .The privacy protection satisfaction was 95.1%, and the female to medical privacy protection satisfaction was lower than the male , and the difference was statistically significant (χ2 =-2.094 , P<0.05 ) .Conclusions The terms of precautions before and during the examinations , the purpose of physical examination project and the education and inform of female health-related knowledge should be strengthened . The flow of physical examination should be improved and the waiting time should be shortened in the process of physical examination .

Objective:To retrospectively analyze the clinical efficacy, safety and the main factors affecting the prognosis of anlotinib hydrochloride in the treatment of advanced primary liver cancer.Methods:Fifty-five cases with advanced primary liver cancer who received anlotinib hydrochloride were enrolled. The baseline data of the patients, such as prothrombin time, total bilirubin, albumin, Child-Pugh score, procalcitonin, alpha fetoprotein, extrahepatic metastasis, cirrhosis, portal hypertension, whether or not combined surgery, pathological staging, etc before treatment were recorded. Hematological and imaging results of the patients were reviewed. Adverse events that appeared in patients at any time until the end of follow-up or loss- to- follow-up or death were recorded. The survival curve was plotted by Kaplan-Meier method, and the difference of survival time between groups was examined by log-rank test. Cox regression model of single and multiple factor were used to analyze the factors affecting the prognosis.Results:As of the last follow-up, 2 patients were lost-to-follow-up, 30 died, and 23 survived. The median survival time was 6.5 months (196 days). Grade 3 or higher adverse events included hypertension (12.73%), leukopenia (3.64%), absolute neutropenia (1.82%), thrombocytopenia (9.09%), fatigue (3.64%), anemia (1.82%), and diarrhea (1.82%). Adverse events were effectively controlled. One case had fatal ruptured esophageal varices, which were not medically related. Multivariate Cox regression analysis showed that total bilirubin ( HR = 0.247, P = 0.003), albumin ( HR = 0.279, P = 0.003) and procalcitonin ( HR = 0.105, P = 0.012) were independent factors affecting the prognosis of advanced HCC. Conclusion:Anlotinib hydrochloride therapy is safe, effective and well tolerated in patients with advanced liver cancer, and total bilirubin, albumin, and procalcitonin are independent factors that affect the prognosis of patients with advanced liver cancer.

Objective To screen and prepare a broad-spectrum monoclonal antibody against Strep-tococcus pneumoniae ( S. pneumoniae) surface protein A ( PspA) and to evaluate its potential in clinical prac-tice. Methods Hybridoma cells were screened and inoculated into the abdominal cavities of BALB/c mice to prepare antibodies in ascites. Monoclonal antibodies were obtained by ammonium sulfate precipitation and protein A affinity chromatography and then identified by SDS-PAGE and Western blot. Their specificity, iso-forms and killing activities in vitro were analyzed. Results A broad-spectrum monoclonal antibody that rec-ognized PspA subclasses 2, 3 and 4 was obtained. Its in vitro killing rate against S. pneumoniae reached 40. 3％. Conclusions A broad-spectrum monoclonal antibody that could specifically bind to PspA was suc-cessfully prepared with a strong in vitro killing activity. This study provided reference for clinical diagnosis of S. pneumoniae-related diseases, quality assessment of S. pneumoniae vaccines and further research on mono-clonal antibody therapeutics.

Objective This study aims to determine the fissure morphology, prevalence, and severity of caries in the first permanent molars of 7-year-old to 9-year-old children in the Dalian development area. The study also aims to investigate the relationship between fissure morphology and noncavitated lesions. Methods A multi-stage, cluster sampling method was used. Three schools were randomly selected from 20 elementary schools in the Dalian development area. All of the children in the selected schools completed clinical oral examinations. A diagnosis criterion of the International Caries Detection and Assessment System was used to assess the cavitated and noncavitated dental caries in the first permanent molars. Fissure depth and fissure stain were also assessed. Results The total size of the study sample was 1 160. The prevalence of cavitated caries was 19.1%, and the mean D3-6FT score was 0.31. No significant differences were found between urban and rural sub-jects, between men and women, and among different age groups. The prevalence and D1-2FT score of noncavitated caries were 42.1% and 0.86, respectively. The D1-2FT score for rural children was significantly higher than that for urban children, and the D1-2FT score for girls were higher than that for boys. No statistical differences were found among different age groups. The prevalence of deep fissures in the first permanent molars was 44.7%. The prevalence of noncavitated caries increased with increasing fissure depth. Conclusion The prevalences of noncavitated caries and deep fissure in the first permanent molars of 7-year-old to 9-year-old children in Dalian were high. Fissure morphology was found to be related to noncavitated caries.

Objective To study the compliance of forbidden depasturing livestock on the marshland with Oncomelania snails in schistosomiasis endemic areas. Methods According to 3 levels of human infection rates as > 10% ,5%-10% and <5% , 2 204 residents selected randomly from the schistosomiasis endemic villages were sampled with the stratified cluster sampling method in Hunan, Hubei, Jiangxi, Anhui, Jiangsu, Sichuan and Yunnan provinces, and investigated by questionnaire. The contents of the questionnaire included the recognition and implementation of forbidden depasturing livestock on marshland with Oncomelania snails and breeding livestock in bam. Results A total of 78.4% residents agreed forbidden depasturing livestock on marshland with snails, but 3. 7% residents disagreed it. A total of 83. 9% residents considered the relationship between breeding livestock in bam and schistosomiasis control, but 3. 1% residents thought that it was no relationship. The main reasons of depasturing livestock on marshland with Oncomelania snails were the high cost of breeding livestock in bam (36. 2% ) , unaccustomed (26.4% ) and no room for breeding livestock in bam (25.4% ). Conclusion Forbidden depasturing livestock on the marshland with Oncomelania snails should be strengthened according to the local economic, nature environment, agriculture, residents'culture degree and agriculture habit.

Objective:To analyze the satisfaction of referral patients for the medical services provided by the countywide medical community, for reference in further improving its quality and continuity of medical services.Methods:From April to July 2021, a systematic sampling method was adopted to selected the survey subjects from the outpatients from the leading hospitals and three affiliated units of two medical communities, as well as those from two county-level hospitals of non medical communities and five grass-roots medical and health institutions. A total of 660 patients were included in the questionnaire survey. The questionnaire covered key demographic information and 15 satisfaction questions under 4 dimensions. The propensity score matching method was used to reduce confounding factors, factor analysis was used to calculate the satisfaction of referral patients in the medical community group and the non-medical community group, and the systematic dynamics approach was used to analyze the effect of patient satisfaction on referral intention.Results:A total of 641 valid questionnaires were collected. Based on a 1∶2 propensity score matching, 591 patients were finally enrolled, consisting of 102 up-referral cases from the non-community group and 273 such cases from the community group, as well as 76 down-referral cases from the non-community group and 140 such cases from the community group. The overall satisfaction scores by both up and down referral patients were 4.26(1.01)and 4.29(1.14)respectively.The overall satisfaction, medical service satisfaction, technical service quality satisfaction and non-technical service quality satisfaction of up-referral patients, as well as the overall satisfaction, non-technical service quality satisfaction of down-referral patients of the community group were higher than those from the non-community group, with differences statistically significant( P<0.05). The higher satisfaction of patients with their referral in the community, the stronger their referral willingness. Conclusions:The overall satisfaction of refrerral patients in the medical community group is higher than that of the non medical community group. The construction of county medical community has promoted the improvement of satisfaction of referral patients. However, it is still imperative to encourage high-quality medical resources to support primary institutions, to enhance the service level of primary medical and health institutions, to implement differentiated medical insurance reimbursement policies, and to improve the continuity of medical services within the community.